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Defining The Business Value Of Technology
September 27, 1999
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"We used to pull a lot of manual reports together and hope the deal we were making was a good one; this system lets us pull the data quickly, do what-if scenarios, and decide whether or not to enter a managed-care agreement under negotiation," Fotopoulos says.
The Internet is also playing a big role in helping health-care providers and insurers get a competitive edge. Aetna Inc. in Hartford, Conn., a $22 billion HMO with 22 million members, is redirecting its entire business to the customer. That includes its E-health initiative, where "we take what we do today and dot-com it," says CIO John Brighton.
Competitive Edge
For example, the company has huge data warehouses containing information about every claim paid during the last two years. Brighton wants to make it so Aetna can approve a claim and wire members money over the Internet in 10 seconds instead of several days. Doing this will also eliminate the storage required for its data warehouses.
Brighton is also looking at leveraging another data warehouse with patient-care information on 16 million people-"every encounter, referral, medical and dental visit, every prescription," he says. The idea is to use predictive modeling to find out, based on a patient's age, lifestyle, and past medical history, what ailments he or she would be susceptible to and suggest lifestyle changes to prevent those ailments.
"We recently went into the database and queried the 16 million records for anything relating to diabetes, including treatment, drugs, and prescriptions. We found 2,500 people who'd have to go on some kind of diabetic treatment, including 24 who'd need to go for eye surgery," Brighton says. "Think how much you could help diabetics if you could catch the disease in time to keep them from going blind."
The database is a 12-terabyte system running on Universal DB2 on 130 IBM RS/6000 SP2 Silvernode multiplex parallel processors linked over a 100-Mbps Ethernet backbone using TCP/IP. It's for internal use, and Brighton is considering providing general access via the Web to Aetna's members. In order to leverage the Web, Brighton plans to partner with vendors. "Not everybody has the skill sets they need, and we're talking to big players in the industry about working together."
Web Access For Physicians
Universal Health Services is implementing the Physicians Access Gateway Enterprise, a system for physicians to access clinical data via the Web, which will be more user-friendly than an existing system. Physicians currently use dialup modems and character-based terminals, limiting their ability to access information.
"They tell me they can't get outpatient information, but all the time this has been in the system," Reino says. Universal Health Services is using Computer Associates' Jasmine technology to provide physicians with Web access to its legacy databases. The rollout will begin at two hospitals, in Texas and Florida, in the fourth quarter, then expand to the rest of the company.
Physicians will be able to access data by pointing and clicking. If the mainframe has two or three screens with related data, Jasmine will call up those other screens and present all three in a combined, easy-to-understand structure. The Web application will require less training than the existing one.
"One of my goals is to achieve user-friendly access, and I might have the incredible experience of having users wanting to use these systems," Reino says.
The main challenge within the health-care industry is that many companies and ventures don't view technology as strategically important, IT executives say. "Many organizations prefer to support the clinical technology and human-resource costs rather than investing in other technology because of limited funds," Verus' Lawry says. "But many of the trends in technology, if implemented, will change the way people work, making things more efficient and cutting the cost of doing business."
Part of the reason is that clinical systems show a clear return on investment, whereas "when you simplify information and remove inefficiencies in business processes, you can't prove that you save any money," Universal Health Services' Reino says. However, things are bound to change.
She predicts: "The industry will forget client-server, which didn't work, and jump to the Web with thin-client applications."
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